CLINICAL FINDINGS IN COMPETITIVE SWIMMERS WITH SHOULDER PAIN

We clinically evaluated 36 competitive swimmers who had shoulder pain; the majority were women, Twenty-three swimmers had unilateral shoulde r pain and 13 had bilateral pain, making a total of 49 painful shoulde rs. Shoulder pain had been present significantly longer in swimmers wi th bilateral shoulder pain (mean, 104 weeks) than in swimmers with uni lateral pain (mean, 33 weeks). Twelve shoulders exhibited signs of imp ingement without excessive humeral head translation. In 25 shoulders, concomitant signs of impingement and increased glenohumeral translatio n, together with a positive apprehension sign, were found. Four swimme rs, who were generally joint hypermobile, exhibited bilateral impingem ent signs and excessive humeral head translation, most commonly in the anteroinferior direction. Four shoulders had excessive humeral head t ranslation and apprehension without impingement. Lack of coordination in the scapulohumeral joint was seen significantly more often in sympt omatic than in asymptomatic shoulders. Hawkins' test for impingement w as more sensitive than Neer's test, Swimmers with shoulder pain have v ariable clinical findings. The majority demonstrate signs of impingeme nt and increased humeral head translation in the anteroinferior direct ion together with a positive apprehension sign. This nontraumatic inst ability might result from wearing of the anteroinferior capsuloligamen tous complex. The different clinical findings might represent differen t stages of the same condition.